An accounting term which refers to a listing of the assets, liabilities and surplus of a Company or Individual as of a specific date.
Tag: RAW
Balance
Amount owed on a credit transaction; also known as the outstanding or unpaid balance .
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A reinsurance underwriter’s benchmark that measures premium volume against the limit exposed under a reinsurance agreement.
Balance bill
1. In third-party payer cases, this is the amount the provider bills the patient after the insurance payment has been posted. This amount may be the copayment and deductible and also the difference between the physician’s fee for medical services and the amount paid by the insurance company. 2. In Medicare cases, the participating physician accepts the Medicare-allowed amount and the patient may not be billed for the balance. The balance difference is not collected and an adjustment entry is posted to the patient’s financial account. However, the patient is also responsible for the 20% copayment and deductible. Also called excess charge . 3. In some plans, this billing amount is limited to the difference between the insurance plan’s allowable fee and the amount paid by the plan. Patients are responsible for copayments, coinsurance amounts, and deductibles.
Balance billing
Act of the provider of medical services to bill the patient for charges not paid by the insurance company. This is prohibited in the Medicare program and some managed care contracts if the physician has accepted assignment. See balance bill . Also called excess charge .
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Billing statement that is sent to the patient after his or her insurance company has paid its portion of the claim.
Balance of a Treaty
The ratio of the total premiums receivable by a reinsurer under a surplus treaty to the reinsurer’s maximum liability for any one claim, based on EML.
Balance of Reinsurance Treaty
Refer: “Reinsurance, Balance of Treaty.”
Balance of Trade
The difference between a country’s total imports and exports; if exports exceed imports, favorable balance of trade exists, if not, a trade deficit is said to exist.
Balance sheet
1. Financial accounting statement that shows the assets, liabilities, and equity of a medical practice. 2. Financial document that contains a tabulated list of the assets and liabilities of an insurance company as of a specific date.
Balance table
A table showing the balance of pension that the employer has to purchase for each employee under a pension scheme.
Balanced Budget Act of 1997 (BBA)
Federal legislation signed and passed on August 5, 1997, that changes sections of the Social Security Act. Its purpose is to reduce spending, balance the federal budget, and fight fraud and abuse. It introduced provisions and improvements to protect program integrity such as permanent exclusion for those convicted of three health care–related crimes on or after the date of enactment and mandated prospective payment systems for outpatient and home health services. Sometimes the Balanced Budget Act of 1997 is informally pronounced as “bubba.”